healthmedicinet

• For 3 million lactose intolerant Britons a glass of milk it is not welcome
• But a genetic mutation in the majority means they can enjoy it for years

By
Guy Walters

PUBLISHED:

20:35 EST, 10 March 2014

|
UPDATED:

20:35 EST, 10 March 2014

When archaeologists investigated two 7,000-year-old corpses unearthed in Spain in 2006, they made two startling discoveries.

One
of the two Mesolithic hunter-gatherers had carried African and European
genes, which meant he had dark skin and blue eyes. But there was an
even more amazing revelation from the scientists when they announced the
results of their research last month.

The man’s genes also showed he  was lactose intolerant.

This is a condition in which the body has difficulty in absorbing the sugar that is commonly found in milk.

For 3m people in the UK a glass of cow juice is about as welcome as being force-fed cod liver oil

A problem drinking milk? What sort of hunter-gatherer was this? Surely food intolerances are a bit modern and namby-pamby?

Well,
I can identify strongly with this Mesolithic milk dodger, as I too
suffer from lactose intolerance. I’m one of the estimated three million
people in the UK for whom a glass of cow juice is about as welcome as
being force-fed cod liver oil.

Much to my regret, I only discovered
that I had the condition last year, when I was going on a punitive
three-day hike through the Yorkshire Dales with a good friend. At one
point, as we were puffing up a particularly strenuous climb, he turned
to me and observed, ‘You do realise that you burp ALL the time?’

At
first, I was in denial. Surely everybody burps a lot? Maybe I was just
bad at hiding it. But by the time we reached the peak, I started to
wonder – not least for the sake of my friendship – whether I did have
something wrong with me. What happened next was like something out of a
film, albeit one that goes straight to video.

On a distant dale, I
saw some cows. There they were, munching away, and the sight of them
suddenly made me realise: Of course, it was milk. Wretched milk.

Until
then, I had dismissed people who claim to have intolerances as being
vain and self-important. I’m not talking about those with allergies,
which are clearly serious, and can be life-threatening. I’m referring to
those annoying people who carp on about being intolerant to this and
that, when they are in fact just fussy eaters.

A genetic mutation in the majority of the population means the ability to drink milk can be enjoyed for years

But it was time to
confront my prejudices. I was going to give up milk. No more breakfast
cereal, no more milk in my tea and coffee. The idea of giving up my
cherished daily bowl of Grape Nuts seemed appalling, but I had to give
it a try.

Within about two days, my belching had almost vanished.
There was no more effervescence, my guts no longer painfully bloated
with gas.

There was no doubt that milk was the culprit.

I had
cracked it, although I did curse that I had not kicked the milk churn
decades before. All those years of subjecting friends and family to
constant burping, all that discomfort needlessly endured, and all
because I hadn’t tolerated those with intolerances.

Initially, I kept
quiet about the whole business, as I didn’t want to be a dietary bore.
And then I came across the startling fact that 75 per cent of the world
has some degree of lactose intolerance. It was another
cow-on-a-distant-dale moment. Hang on, I thought, you people who can
drink milk, it’s you who are the weird ones! Not me, I’m the normal one.

As
it turns out, the ability to tolerate lactose is really only found in
people in northern Europe, North America and in pockets in the Middle
East and western and southern Africa. If you go anywhere else, you’ll
find that everybody is like me and Mesolithic Man.

Why is this? The
answer lies in the enzyme lactase, which breaks down the lactose in
milk. Although all of us are born with lactase, after about the age of
two, the levels in our small intestines diminish rapidly for most
people, which makes it hard for lactose to be broken down, and therefore
causes discomfort, which is often manifested by burping.

But in
countries such as the UK, a genetic mutation in the majority of the
population means that lactase persists, and therefore the ability to
drink milk can be enjoyed for many decades after infancy.

Last month,
British scientists who have studied the residue in cooking pots from
archaeological digs estimated that this mutation may have taken place
6,000 years ago.

Opinion is divided as to why this mutation which
allows some of us to drink milk took place. Some suggest that when our
ancestors started to consume dairy produce, they built up a tolerance
which altered their genes. Others think that the mutation happened
before mammalian milk was drunk, and it allowed dairy consumption to
take place.

12g

The amount of lactose adults with intolerance can cope with in a day. It’s equivalent to a glass of milk

But for people like me, it doesn’t really matter what
came first. I want to know the health implications. After all, it’s
drummed into us from an early age that milk is  an essential part of our
diet, chiefly because all that calcium is good for our bones.

‘There
are no serious health consequences of being lactose intolerant,’ says
Professor John Mayberry, a gastroenterologist at the University
Hospitals of Leicester, ‘and you should remember that for much of the
world it’s quite normal. There’s no increased risk of any diseases.’

You
should also remember milk does not have a monopoly on  calcium, which
is found in broccoli,  cabbage, soya beans and nuts. And just because
you are lactose intolerant, it does not mean you have to give up cheese,
as the fermentation process significantly reduces lactose levels.

Although
Professor  Mayberry confirms that my self-diagnosis is perfectly valid
and safe, there are more medically rigorous tests you can take should
you suspect lactose intolerance.

‘Potentially, you can submit to a
whole series of investigations,’ says Professor Mayberry. ‘But the most
simple and least invasive is the hydrogen breath test, in which the
level of hydrogen in your breath is measured after you have drunk some
lactose solution.’

The test is done at a hospital and you need a GP referral.

Hydrogen
is one of the gases so charmingly emitted by the likes of me after
drinking milk – bacteria in the gut produce hydrogen in reaction to
unabsorbed food, and if your levels of hydrogen are 20 parts per million
higher after drinking the lactose solution, then you’re lactose
intolerant.

In my experience, that figure seems low. At times, I could have sworn I was expelling pure hydrogen.
Another
common test is to measure the levels of glucose in your blood after
drinking lactose. The lactase enzyme breaks down lactose into glucose –
so if your glucose either rises slowly, or not at all after drinking
lactose, it’s a sign of lactose intolerance.

Guy has enough lactase in his small intestine to be able to cope with milk in tea

Again, this hospital test needs a referral from your GP.

Although
Professor Mayberry’s words are reassuring, for some, a lactose
intolerance can actually be a symptom of something more serious.

A
deficiency of lactase can be caused by inflammatory bowel diseases such
as Crohn’s and ulcerative colitis, but as these also present other more
serious symptoms such as weight loss, bleeding and mucus, a diagnosis of
lactose intolerance alone is no reason to be alarmed.

But those who
smugly think they can consume lactose for the rest of their lives
should also think again. ‘Lactase starts to diminish in a lot of people
in their 60s and 70s,’ says Professor Mayberry, ‘which is why older
people find they cannot eat certain food any more.

‘Lactose isn’t just present in milk, but it’s used in all sorts of foods, such as whitener in loaves of bread.’

I’ve
now started to reintroduce milk in a small way. I now take it in tea
and coffee, and like many with lactose intolerance, I have just enough
lactase in my small intestine to be able to cope with these amounts.

For
the time being, I appear not to have passed on my intolerance to my
children, who are both nearly in double figures, and seem able to drink
milk with impunity.

But as soon as one of them emits a tell-tale burp, I’ll snatch the glass, and tell them to leave the rest of the herd.

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